<form method="post">
	<article class="module width_full">
		<header><h3>{#reports#}</h3></header>
		<div class="module_content">
			<fieldset>
				<label>{#title#}</label>
				<input type="text" name="title" value="" >
			</fieldset>
			<fieldset>
				<label>{#message#}</label>
				<textarea rows="10" name="message" style="width:95%;"></textarea>
			</fieldset>
			<fieldset>
				<label>{#close#}</label>
				<input name="close" type="checkbox">
			</fieldset>
			<div class="clear"></div>
		</div>
		<footer>
			<div class="submit_link">
				<input type="submit" value="{#answer#}" name="submit" class="alt_btn">
			</div>
		</footer>
	</article>
</form>
<!-- Addet -->
<div class="modal" id="replayed">
        <h3>{#status#}</h3>
		<p>{#success_replayed#}</p>
</div>
